Noguchi Hirofumi, Yamada Yuichiro, Okitsu Teru, Iwanaga Yasuhiro, Nagata Hideo, Kobayashi Naoya, Hayashi Shuji, Matsumoto Shinichi
Transplantation Unit, Kyoto University Hospital, Kyoto 606-8507, Japan.
Cell Transplant. 2008;17(1-2):121-8. doi: 10.3727/000000008783906991.
The evaluation of engraftment is important to assess the success of islet transplantation, but it is complex because islet transplantation usually requires two or more donors to achieve euglycemia. Islet transplantation from NHBDs was evaluated using new assessment forms for the secretory unit of islet in transplantation (SUIT) and engrafted islet rate (EIR) indexes. Insulin independence was obtained when the SUIT index was more than 28, which might indicate that 28% of the beta-cell mass of a normal subject is required for insulin independence. Because the average EIR for a single transplantation is about 30, the percentage of engrafted islets following one transplantation is about 30%, assuming that a normal subject has 1 million islet equivalents. Although few cultured islet transplants have been performed, the increase of the SUIT and EIR indexes in patients who received cultured islets was significantly lower than in patients who received fresh islets, suggesting that fresh islets may be more effective than cultured islets. The SUIT and EIR indexes are thus considered to be useful values for evaluating islet transplantation, especially for single islet transplantation.
评估胰岛移植的植入情况对于判断胰岛移植是否成功很重要,但这一过程较为复杂,因为胰岛移植通常需要两个或更多供体才能实现血糖正常。使用针对移植中胰岛分泌单位(SUIT)和植入胰岛率(EIR)指标的新评估形式,对来自非心脏死亡供体(NHBDs)的胰岛移植进行了评估。当SUIT指数超过28时可实现胰岛素非依赖,这可能表明胰岛素非依赖需要正常受试者28%的β细胞量。由于单次移植的平均EIR约为30,假设正常受试者有100万个胰岛当量,那么一次移植后植入胰岛的百分比约为30%。尽管很少进行培养胰岛移植,但接受培养胰岛的患者中SUIT和EIR指数的增加明显低于接受新鲜胰岛的患者,这表明新鲜胰岛可能比培养胰岛更有效。因此,SUIT和EIR指数被认为是评估胰岛移植,特别是单次胰岛移植的有用指标。